HAO Peng , YANG Liu , HE Rui , CHEN Hao , SUN Maolin , LIANG Shuainan
  • Center for Joint Surgery, the First Affiliated Hospital, Army Medical University, Chongqing, 400038, P.R.China;
YANG Liu, Email: jointsurgery@163.com
Unicompartmental knee arthroplasty; total knee arthroplasty; osteoarthritis; gait analysis; gait symmetry
10.7507/1002-1892.202004076
Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables References Cited by

Objective To explore the gait trajectory characteristics and effectiveness after unicompartmental knee arthroplasty (UKA).Methods Thirty patients (30 knees) with anterior medial compartment osteoarthritis who were treated with UKA between January 2017 and December 2018 were selected as subjects (UKA group). According to age, gender, and side, 30 patients (30 knees) with knee osteoarthritis treated with total knee arthroplasty (TKA) were selected as control (TKA group). In addition to the range of motion (ROM) before operation showing significant difference between the two groups (t=4.25, P=0.00), there was no significant difference in gender, age, disease duration, sides, body mass index, and preoperative hip-knee-ankle angle (HKA), Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score between the two groups (P>0.05). The incision length, drainage volume within 24 hours after operation, and the changes of hemoglobin and albumin were recorded. The WOMAC score, ROM, and HKA before and after operation were compared between the two groups. At 1 year after operation, the gait trajectory characteristics of two groups were analyzed by Vicon three-dimensional gait capture system, and the absolute symmetry index (ASI) of the lower limbs of the two groups was calculated.Results The incisions of the two groups healed by first intention, with no complications. The incision length, drainage volume within 24 hours, and the changes of hemoglobin and albumin after operation in the UKA group were significantly smaller than those in the control group (P<0.05). All patients were followed up completely, the follow-up time ranged from 13 to 20 months of UKA group (mean, 18 months) and 16 to 24 months of control group (mean, 20 months). The imaging review showed that the lower limb alignment of the two groups were restored to a neutral position, and the position of prosthesis was good. At 1 year after operation, the WOMAC score, HKA, and ROM of two groups were significantly improved when compared with those before operation (P<0.05); the postoperative WOMAC score and ROM of the UKA group were significantly better than those of the control group (P<0.05), and there was no significant difference in HKA between the two groups (t=1.54, P=0.13). Gait analysis at 1 year after operation showed that the walking speed, stride length, knee extension at mid-stance, and flexion at swing in the UKA group were significantly better than those in the TKA group (P<0.05); there was no significant difference in cadence, knee flexion at initial contact, and knee flexion at loading response between the two groups (P>0.05). The ASI of bilateral knee flexion in the UKA group was significantly greater than that in the TKA group during the initial contact and loading response period (P<0.05).Conclusion Compared with TKA, UKA has the advantages of small incision, less blood loss, and quicker functional recovery. The early gait after UKA is mainly manifested as the increase in walking speed, stride length, knee flexion at swing, and extension at mid-stance phase. From the analysis of gait symmetry, during the initial contact and loading response phase, the operation side after UKA undertakes more shock absorption and joint stabilization functions than the contralateral side.

Citation： HAO Peng, YANG Liu, HE Rui, CHEN Hao, SUN Maolin, LIANG Shuainan. Analysis of gait and effectiveness after unicompartmental knee arthroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(11): 1369-1375. doi: 10.7507/1002-1892.202004076 Copy

  • Previous Article

    Effectiveness of percutaneous compression plate fixation for femoral neck fractures

  • Next Article

    An animal experimental study on domestic robot-assisted total knee arthroplasty